Early Remote Rehabilitation to Improve Health of the Elderly After Cardiac Surgery. (RECARD Trial)
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Early mobile health intervention supplemented by weekly calls from a physiotherapist.
- Who it may be relevant to
- Registry conditions: Cardiac Rehabilitation. Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Denmark
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Early REmote Rehabilitation to Improve Health of the Elderly After CARDiac Surgery. (RECARD Trial). A Bi-center, Prospective, Randomized, Open-label, Blinded Evaluation (PROBE) Trial
Overview
An increasing number of older patients undergo heart surgery. Despite seemingly successful outcomes, these vulnerable patients may face prolonged decreased functional capacity, reduced self-efficacy, and impaired quality of life after discharge. Early engagement in physical activity and education plays a key role in health and well-being after heart surgery The goal of this clinical trial is to evaluate the effectiveness of an app-based exercise program and weekly calls from a physiotherapist in the early stages after open heart surgery. Eligible patients will be randomly assigned to either a control group receiving standard care or an intervention group, which will be introduced to an individually tailored exercise program as an addition to standard care. Follow-up is planned with an out-patient visit six weeks after discharge and a telephone interview six months post-surgery. All participants will undergo assessments at enrollment and during follow-up. Physical performance will be evaluated through physical tests. General well-being, quality of life, self-reported physical activity, and cost-effectiveness of the intervention will be assessed through questionnaires. Muscle health will be examined through blood sampling, CT scans, and muscle biopsies. The primary endpoint is the 30-second Chair Stand Test serving as a measurement of physical function.
Detailed description
Hypotheses:
Primary: Early mobile health intervention at home supplemented by weekly calls from a physiotherapist after cardiac surgery improves functional outcomes, exercise tolerance, and quality of life in older patients.
Secondary:
* Cardiac surgery increases the prevalence and extent of sarcopenia in the elderly which can be mitigated by early mobile health intervention * Sarcopenia on Chest Computed Tomography (CCT) is strongly correlated to functional outcome and quality of life following cardiac surgery * Early mobile health intervention is feasible and cost-effective
Design:
This is a bi-center, prospective, randomized controlled, parallel, two-arm, open-label, blinded evaluation (PROBE) trial with a superiority design. The study population will consist of a representative group (n=120) of older patients scheduled for open heart surgery who fulfill the requirements according to inclusion and exclusion criteria. The patients will be recruited from 2 cardiac surgery centers in northern and central Denmark.
Patients are stratified after center and subsequently randomly allocated (1:1) to receive mobile health intervention as an adjunct to standard care (Intervention Group), or standard care alone (Control group) for 6 weeks after discharge. Follow-up is planned with an outpatient visit 6 weeks after discharge, and a telephone interview 6 months after surgery.
Patients in the intervention group receive a 6-week home-based CR using the ICURA app and sensor-based technology (ICURA ApS, Copenhagen, Denmark). During the hospital stay patients in the intervention group are introduced to the app's usage, and an individualized training plan is collaboratively created and subsequently tailored by a physiotherapist. The patients are equipped with a case including an ICURA -sensor with a charger, an illustrative quick guide, and a contact telephone number. According to the patient's preference, the app is either installed on their own mobile phone or provided on a separate mobile device.
The comprehensive mobile health intervention includes customized training programs, activity tracking, visualization of exercises with videos, text message communication with patients, and a password-protected webpage for physiotherapists to customize training programs and track patient activity.
A few days after discharge, patients in the intervention group will receive the first call from the physiotherapist, to ensure, that the patient is using the ICURA app actively. The patients will receive two calls per week for the first two weeks and as required the following four weeks.
Interventions
- Device Early mobile health intervention supplemented by weekly calls from a physiotherapist
Six-week home-based rehabilitation program using the ICURA app and sensor-based technology (ICURA ApS, Copenhagen, Denmark). During the hospital stay patients in the intervention group are introduced to the app's usage, and an individualized training plan is collaboratively created and subsequently tailored by a physiotherapist. The comprehensive mobile health intervention includes customized training programs, activity tracking, visualization of exercises with videos, and a password-protected
Primary outcome measures
- Change (Δ) 30-second chair stand test (30CST) baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after surgery]
Secondary outcome measures (12)
- Change (Δ) in 10-meter Walk Test (10MWT) baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge]
- Difference in 6-minute Walk Test (6MWT) between groups at 6-week FU [Time frame: 6 weeks (+/- 4 days) after discharge]
- Change (Δ) in WHO-5-score baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Change (Δ) in ASS-2-score baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Change (Δ) in MDI-2-score baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Change (Δ) in Self-reported Physical Activity baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Change (Δ) in EuroQol-score baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Change in skeletal muscle mass baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge]
- Cost-effectiveness analysis [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge and 6 months after surgery]
- Changes in markers of musculoskeletal health through blood samples baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge]
- Changes in markers of inflammation through blood samples baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge]
- Changes in markers of nutrition through blood samples baseline vs. 6-week FU [Time frame: 1-7 days prior to surgery and 6 weeks (+/- 4 days) after discharge]
Eligibility criteria
Inclusion criteria
- Provision of signed and dated informed consent form
- Scheduled first-time heart surgery through median sternotomy
- Male or female, aged ≥ 65 years (The age criterion implies the exclusion of women of childbearing potential)
Exclusion criteria
- Medical conditions requiring referral to specialized rehabilitation (e.g., severe heart or lung failure, need for blood pressure monitoring during exercise)
- Emergent procedure
- Anticipated inability to perform intervention, study assessment procedures, or follow-up
- Participation in any other interventional clinical that may interfere with the outcome measures
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Denmark · 2 centers
- Aarlborg University Hospital — Aalborg
- Aarhus University Hospital — Aarhus
Publications
- Daugaard R, Sorensen L, Ingemann-Molden S, Modrau IS. Early remote rehabilitation to improve health of the elderly after cardiac surgery - study protocol for a randomised trial. Dan Med J. 2025 Jun 21;72(7):A11240820. doi: 10.61409/A11240820. PMID 40600679
Identifiers
NCT: NCT06370611 · 2314027